Director of Nursing

Job Overview Summary:


Provides leadership to the nursing department by assuming responsibility and accountability for all nursing and clinical services. Ensures the highest quality of care is provided to patients. Ensures the delivery of quality care by establishing systems for care, managing and coaching employees to provide that care, and managing to a budget. Develop and train employees through continuous education, mentoring and leading by example.


Note: The following duties are illustrative and not exhaustive. The omission of specific statements of duties does not exclude them from the position if the work is similar, related, or a logical assignment to the position. Depending on assigned area of responsibility, incumbents in the position may perform some or all of the activities described below.


Functions:

• Leadership:
• Develop a clinical vision for the building, and translate that vision into actionable goals for the nursing department
• Establish and prioritize goals of the nursing department and hold regular meetings with nursing staff to ensure they know and understand the goals and policies and procedures of the department and to increase their sense of involvement and satisfaction
• Conduct monthly nursing staff meetings on each shift, share information and solicit feedback from staff
• Attend care plan meetings
• Attend DON and Administrator meetings as scheduled
• Adhere to the disciplinary process with direct reports and ensure the process is followed
• Clinical Integrity
• Responsible for the delivery of high quality, standardized care to patients
• Manage the implementation of programs (e.g., falls, restorative, at-risk) to deliver quality care and prevent survey deficiencies
• Demonstrate clinical expertise and critical thinking to resolve patient issues
• Examine discharge process to ensure discharges are safe, patient needs are met and the appropriate criteria are used to make discharge decisions
• Conduct rounds to ensure delivery of quality care
• Ensure customer satisfaction and Resident Rights by working with interdisciplinary team
• Responsible for investigating and reporting incidents as appropriate
• Responsible for monitoring and improving the quality of clinical care delivered to patients
• Determine trends in clinical care by analyzing indicators and identifying potential areas of opportunity
• Based on analysis of indicators, develop programs and create action plans to address trends and improve quality of care
• Prepare clinical reports as requested by Directors of Clinical Operations
• Work with MDS Coordinator to ensure accuracy of clinical data
• Ensure nursing audits are completed
• Responsible for maintaining compliance by planning for survey and managing the implementation of action plans
• Responsible for participation and preparation of mock surveys
• Analyze past survey data to prevent deficiencies and remain in compliance at all times
• Ensure that adequate clinical services are being provided to patients, resulting in achieving less than the state average in annual survey tags, with scope and severity no greater than D or E. Complaint Survey(s), should not result in scope and severity greater than G. Ensure that all tags are cleared on first re-visit in every survey
• Serves as a key point-of-contact during survey
• Create and manage the implementation of action plans based on survey results to prevent future deficiencies
• Educate staff on proper protocol when interacting with surveyors
• Attend at-risk meetings to ensure patient interventions occur and care plans are properly updated
• Minimize clinical risks by conducting daily rounds and ensuring that facility is in compliance with policies and procedures and with state and federal regulations
• Analyze unplanned discharges in order to help prevent future unplanned discharges from occurring by working with Social Services, Nursing, and Medical Director to ensure appropriate training of nursing staff
• Identify problems and deficiencies and develop and implement appropriate action plans to address and correct deficiencies and ensure compliance with Federal, State, and Local standards
• Periodically review clinical areas to ensure compliance with Federal, State, and Local standards
• Census Development
• Participate in discharge planning for each new patient
• Initiate contact with hospital discharge planners and physicians as applicable
• Develop relationships with referral sources (e.g., home health nurses, physicians, etc.) and educate them about facility capabilities to differentiate the Facility from the competition and increase likelihood of patient referrals
• Establish a relationship with the Liaison to create mutually-understood expectations regarding admissions
• Ensure clinical capability to deliver care (i.e. match clinical capabilities to care demand) and determine equipment for special needs
• Educate the Liaison on the clinical capabilities of the facility so that information can be communicated to referral sources
• Participate in marketing the facility by giving tours and meeting with referral sources as necessary
• Control Labor
• Manage PPD budget, utilizing platforms such as OnShift, to ensure that facility operates within its labor cost budget
• Recruit, interview, hire, and orient staff
• Manage the recruitment plan to increase applicant flow to address staffing, retention and recruitment needs
• Recognize and reward employees to promote a positive and productive work environment
• Ensure that facility has sufficient and qualified staff to deliver quality care to the residents
• Accountable for Jazz HR utilization to ensure that every applicant is tracked and application outcome is documented
• Participate in accurately maintaining data for Payroll Based Journal (PBJ) reporting such as employee and contract hours
• Ensure that attendance policies are consistently applied and enforced by gathering absences and tardiness on a weekly basis and following through
• Cash Collection
• Use budget spend down worksheet to manage all other associated costs (e.g. supplies, purchase services, food, equipment) in correlation with fluctuation in census to ensure that non-labor facility operating expenses are within the annual budget PPD parameter and meet overall cost targets
• Determine areas that are off budget by establishing, reviewing, and analyzing monthly financial statements
• Work with Admissions, Social Services, Business Office, and Nursing to minimize A/R
• Minimize unplanned discharges to maximize the gross margin and provide individualized patient care
• Adjust labor hours to ensure PPD is maintained
• Customer Service/Communication
• Treat staff and patients with dignity and respect and model these values in daily behavior to encourage such behavior from all facility staff, to achieve high levels of staff morale and satisfaction, and to ensure patient satisfaction
• Communicate openly, clearly and effectively to all customers (patients, families, vendors, employees, etc.)
• Provide a platform for customers to offer feedback and opportunities for improvement
• Respond appropriately and timely to all internal and external customer concerns
• Manage patient satisfaction by ensuring that residents receive appropriate level of care
• Meet with facility staff on all three shifts and listen to and address their concerns to ensure their grievances are met and that they are satisfied and can provide appropriate level of service to the residents
• Monitor resolution to patient and/or family members' concerns by following grievance procedure and keeping it up-to-date
• Monitor call lights to ensure that they are responded to timely
• Conduct daily rounds, and talk to staff, patients and families to ensure that appropriate level of care is provided

Qualifications:

• Graduate of an accredited RN school of nursing required
• Valid RN license in the state employed required
• Valid CPR certification required
• Prior skilled nursing management experience required
• Bachelor's degree in nursing preferred

Knowledge and Skills:

• Demonstrates leadership, organizational and critical thinking skills
• Effective interpersonal and communication skills
• Ability to work independently, problem solve and make decisions as necessary
• Advanced knowledge of computers
• Ability to be patient while interacting with challenged or difficult residents
• Ability to create a resident-centered environment
• Ability to work with a diverse staff and client base
• Ability to react decisively
• Ability to react quickly in emergency situations
• Knowledge of policies and procedures and state and federal regulations

Required Responsibilities:


Successful demonstration of work standards, quality work product, productivity, and job knowledge are standard expectations for all company employees.


Core Competencies:

• Caring/Compassion
• Accountability
• Dependability
• Adaptability/Flexibility
• Effective Communication
• Detail Oriented
• Confidentiality
• Team Player
• Dedication

Physical Demands

Shoe the amount of time on-the-job in the following physical activities by checking the appropriate boxes below.

Amount of Time

NoneOccasionally up to 1/3Frequently 1/3 to 2/3Constantly 2/3 or more

Stand x


Walk x


Sit x


Talk or hear x


Finger, handle or feet x


Push/pull x


Stop, kneel, crouch or crawl x


Reach with hands and arms x


Taste or smell x


This job requires that force be exerted by weight being lifted, carried, pushed, or pulled. Show how much and how often by checking the appropriate boxes below.

NoneOccasionally up to 1/3Frequently 1/3 to 2/3Constantly 2/3 or more

Up to 10 lbs x


Up to 20 lbs x


Up to 50 lbs x


Up to 100 lbs x


> 100 lbs x


This job has special vision requirements.

• Close Vision (clear vision at 20 inches or less)
• Distance Vision (clear vision at 20 feet or more)
• Color Vision (ability to identify and distinguish colors)
• Peripheral Vision (ability to observe an area that can be seen up and down or to the left and right while eyes are fixed on a given point)
• Depth Perception (three-dimensional vision; ability to judge distances and spatial relationships)
• Ability to Adjust Focus (ability to adjust eye to bring an object into sharp focus)
• No Special Vision Requirements

This job has special hearing requirements.

• Ability to hear alarms on equipment
• Ability to hear client call
• Ability to hear instructions from physician/department staff